The Larimer County Board of Health convened its regular
meeting at 7:00 PM at the Larimer County Department of Health and Environment,
1525 Blue Spruce Drive, Fort Collins, CO.

MEMBERS PRESENT: Lee
Thielen, M.P.A

Teri
Olson, R.N., M.S.N.

Judy
Robinson, B.S.N., M.P.H.

N.
Mark Richards, M.D., M.P.H. via telephone

Adrienne
LeBailly, M.D., M.P.H.

OTHERS PRESENT: Marie
Macpherson, Bruce Peters, Ed Schemm,

Averil
Strand, Warrenetta Underwood, and Amy

Smith

Commissioner
Kathay Rennels via telephone

1.
Call to order

Meeting was called to order at 7:08 PM

2.
Approval of the Minutes of March 13, 2008

Minutes of March 13, 2008 were unanimously approved

3.
Reproductive Health Program update – Nettie Underwood

Dr. LeBailly introduced Nettie
Underwood, the Assistant Director of Community Health services. Ms. Underwood described
the Family Planning (Title X) program, which offers a broad range of contraceptive
methods and services, as well as natural family planning and fertility
services. She informed them that teens under 18 can receive services according
to the Colorado Statutes, though the Health Department does encourage parental
involvement. Ms. Underwood shared with the BOH members that over 4,400 clients
were served in our family planning clinic, out of 51,000 clients served
throughout the state of Colorado in 2007.

Ms. Underwood reported on the
success of our partnership with the Larimer County Human Services department, which
supports us in a project to reduce out-of-wedlock pregnancies. Their funding
has helped us cover some very large increases in contraceptives costs. It has
also helped up cover the cost of outreach to low-income women and high-risk
teens.

Ms. Underwood explained that the
Health Department receives federal Title X funds through the State of Colorado and
that we have been asked to participate in the federal audit that will be done
this fall. The feedback from the state consultants has been very positive
concerning our family planning program.

Ms. Underwood explained that in
addition to Family Planning clients, we also treat patients with sexually
transmitted diseases (STDs) in the Reproductive Clinic. Our Department is required
to report all STD patients that we see to the State Health Department, but we do
not receive reports from the state on STD patients seen by private providers in
Larimer County. The state currently follows up on some STD cases—those with
HIV, syphilis, and rectal/oral gonorrhea—but not on cases of chlamydia or
genital gonorrhea. This has led to some patients or their partners falling through
the cracks, and has impaired our ability to monitor increases in STD rates in
the county. Ms. Underwood also explained the STD disease control specialist
who used to perform these services for the northeastern area of the state was
reassigned to the Denver-metro area, which has resulted in fewer resources to
be available for prevention and follow-up in Weld and Larimer Counties.

Dr LeBailly reported that recent
statistics on Larimer STDs show gonorrhea, syphilis, and chlamydia are on the
rise. The state has integrated their STD and HIV programs and, because of
this, their data system requires a very high level of security, and they have
not allowed our local Health Department to gain access to it. The state does
not do follow-up or partner notification for numerous patients, nor do they
give us the information that would allow us to do the follow-up. Since we have
not performed this function in over a decade, we would have to discuss whether
we would take on this responsibility, as we have no additional resources to do
so. Dr. Richards expressed his serious concern that we cannot let the critical
function of STD follow-up and partner notification remain undone, both to find
unrecognized cases and prevent new infections.

Dr. LeBailly will be meeting with
the head of the head of the State STD program on May 9, 2008 to discuss the situation and try to come up with options to improve the situation and will keep
the board informed about the outcome.

4.
Increase in Septic Permit Fees – Marie Macpherson

Marie Macpherson distributed a
spreadsheet (attached on last page) showing Health Department costs for issuing
septic permits with two options for the BOH to consider for increasing revenues
to come closer to cost recovery for the program. Ms. Macpherson reviewed the
minutes from the Board of Health meeting held on January 18, 2007, which stated
the motion had been unanimously approved to increase the fees for new
residential septic permits to current levels, with the understanding that
Septic Permit Fees would be revisited in one year with the goal of full cost
recovery over a short time period.

Bruce Peters explained the two
options for potential increases included in the spreadsheet based on changes
made in the program over the past year. Ed Schemm explained that the total costs
include a review of the design of the septic, a field visit, issuance of the
permit, at least one final inspection (sometimes two, depending on the system),
plus additional overhead expenses such as administrative costs. Mr. Peters
also distributed a comparison of septic permit fees for 2007/ 2008 for some other
Front Range counties.

Discussion ensued about the amount
of septic permitting activity expected in the upcoming year, the cost per unit
for permits, the reorganization of the program done in 2007 to deal with
reduced demand for permits, and the reason that repair permits are not recommended
to increase.

Commissioner Rennels shared her
concerns about the higher fee increase option (Option B) because of the good
support from the septic installers with the increase implemented last year.

There was discussion of which
option would be the most feasible in view of the need to decrease fund balance
usage, the county budget situation, the economy, and the effects on the
community.

Motion was made to implement Option
A for 2008’s septic permit fees.

Motion was unanimously
approved.

The BOH members suggested to set
the goal for the effective date to be May 1, 2008; with the knowledge of the
permits that are already in process will be honored.

5.
Review of Board of Health Evaluation Tools – Lee Thielen

Ms. Thielen shared several examples
of a tool for evaluating Board functions that the Board of Health might want to
consider using. The members selected two forms to try to combine into a single
tool. Ms. Thielen agreed to create a draft form to bring back to the board for
further review.

6.
Discussion of 2008 Jabaily Award nominations

The BOH members reviewed the
nominations presented. After discussing the merits of each nominee, the Board
members were ready to make their decision.

Motion was made and unanimously
accepted to present the award to Dr. Jane Higgins.

Dr. Higgins will be invited to the
next BOH meeting to receive the Joe Jabaily award.

7.
Director’s Report – Adrienne LeBailly, MD

Dr. LeBailly asked Ms. Thielen if
she would review the latest legislation as she may have more recent knowledge
of the current bills. Ms. Thielen shared information about Senate bill 194,
the Public Health Reorganization bill. Some industry lobbyists are concerned
that local agencies would have more authority than they do now. But she stated
the bill is not about authority, it’s actually about changing structure and
planning. She added that this bill would go to the floor of the Senate soon.

There was discussion of a bill making
adolescent possession of tobacco a crime. Many public health advocates tend
not to support the idea that such behavior should be criminalized. The bill
was added on to another bill after it went through all the

committees. There may be expectations that Public Health agencies will be the
enforcers of this bill.

Dr. LeBailly distributed a report
from the Trust for America’s Health which contained information about how federal
health dollars are allocated in Colorado.

Dr. LeBailly informed the BOH that
the Pandemic Flu tabletop exercise will take place on May 2, 2008; approximately 60 have confirmed. Commissioner Rennels offered to attend if there is space
available.

Dr. LeBailly distributed the new
brochures of Larimer County Health and Environment.

8.
The next Board of Health meeting will be held on May 8, 2008[subsequently moved to June 12.]